Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Int J Cancer. 2019 Jul 15;145(2):347-359. doi: 10.1002/ijc.32109. Epub 2019 Feb 12.
Overweight/obesity, adult attained height and physical activity are possible risk factors for hematological malignancies. This meta-analysis aims to evaluate the associations between these factors and hematological cancer risk in adults. Eligible cohort studies were sought in PubMed up to May 31, 2016; overall, 44 studies were included in the present analyses. Pooled relative risk estimates were calculated using random-effects models; separate analyses were conducted for non-Hodgkin lymphoma (NHL) and subtypes (diffuse large B-cell lymphoma, DLBCL; follicular cell lymphoma; small lymphocytic lymphoma/chronic lymphocytic leukemia, SLL/CLL), Hodgkin lymphoma (HL), multiple myeloma (MM), leukemia and subtypes (acute lymphoblastic leukemia, acute myeloid leukemia, AML). Obesity was associated with increased risk of NHL, HL, MM, leukemia overall and AML in both sexes, as well as with higher DLBCL risk in women; the dose-response meta-regression analysis confirmed these associations. Less pronounced effects were observed regarding overweight, as it was associated with increased MM risk in both sexes, NHL risk in males, DLBCL and overall leukemia risk in females. Taller men presented with significantly higher risk of NHL and taller women were affected by higher risk of NHL, DLBCL, FL, CLL/SLL, MM, leukemia and AML. On the other hand, physical activity and abdominal fatness were not associated with the risk of hematological malignancies. In conclusion, this meta-analysis highlights the pivotal role of anthropometric measures in shaping the risk of hematological malignancies in adults. Additional, well-designed studies stemming from all the continents are needed for the further substantiation and generalization of the results.
超重/肥胖、成人身高和体力活动可能是血液系统恶性肿瘤的危险因素。本荟萃分析旨在评估这些因素与成年人血液癌风险之间的关系。在 PubMed 中检索截至 2016 年 5 月 31 日的合格队列研究；本分析共纳入 44 项研究。使用随机效应模型计算汇总相对风险估计值；分别对非霍奇金淋巴瘤（NHL）和亚型（弥漫性大 B 细胞淋巴瘤，DLBCL；滤泡细胞淋巴瘤；小淋巴细胞淋巴瘤/慢性淋巴细胞白血病，SLL/CLL）、霍奇金淋巴瘤（HL）、多发性骨髓瘤（MM）、白血病和亚型（急性淋巴细胞白血病，急性髓细胞白血病，AML）进行了分析。肥胖与男性和女性 NHL、HL、MM、白血病和 AML 的发病风险增加以及女性 DLBCL 风险增加相关；剂量-反应荟萃回归分析证实了这些相关性。超重的相关性不太明显，与男性 MM 风险增加、男性 NHL 风险增加、女性 DLBCL 和总白血病风险增加相关。高个子男性 NHL 发病风险显著增加，高个子女性则受 NHL、DLBCL、FL、CLL/SLL、MM、白血病和 AML 发病风险增加的影响。另一方面，体力活动和腹部肥胖与血液系统恶性肿瘤的风险无关。总之，本荟萃分析强调了人体测量指标在塑造成年人血液恶性肿瘤风险方面的关键作用。需要来自所有大洲的进一步精心设计的研究来进一步证实和推广这些结果。
